Sebastian Bouroncle Dds-1 Pllc
NPI #1740667799 in Woodbridge, Virginia
Provider Information
- NPI Number
- 1740667799
- Entity Type
- Organization
- Organization Name
- Sebastian Bouroncle Dds-1 Pllc
- Primary Specialty
- Dentist
- Enumeration Date
- Apr 29, 2015
- Last Updated
- Apr 29, 2015
Practice Location
- Address
- 1900 OPITZ BLVD
- Address 2
- STE C
- City
- Woodbridge
- State
- Virginia
- ZIP Code
- 22191-3320
- Phone
- (703) 494-0820
Authorized Official
- Name
- MRS. VIRGINIA T DE CASTRO
- Title
- OFFICE MANAGER
- Phone
- (703) 494-0820
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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